{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:36:25Z","timestamp":1772138185496,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54 EB027690 02S1"],"award-info":[{"award-number":["U54 EB027690 02S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54 EB027690 03S1"],"award-info":[{"award-number":["U54 EB027690 03S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54 EB027690 03S2"],"award-info":[{"award-number":["U54 EB027690 03S2"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1 TR002378"],"award-info":[{"award-number":["UL1 TR002378"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coronavirus disease 2019 (COVID-19) testing policies for symptomatic children attending US schools or daycare vary, and whether isolated symptoms should prompt testing is unclear. We evaluated children presenting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing to determine if the likelihood of having a positive SARS-CoV-2 test differed between participants with 1 symptom vs \u22652 symptoms, and to examine the predictive capability of isolated symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants aged &amp;lt;18 years presenting for clinical SARS-CoV-2 molecular testing in 6 sites in urban\/suburban\/rural Georgia (July\u2013October, 2021; Delta variant predominant) were queried about individual symptoms. Participants were classified into 3 groups: asymptomatic, 1 symptom only, or \u22652 symptoms. SARS-CoV-2 test results and clinical characteristics of the 3 groups were compared. Sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) for isolated symptoms were calculated by fitting a saturated Poisson model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 602 participants, 21.8% tested positive and 48.7% had a known or suspected close contact. Children reporting 1 symptom (n\u2005=\u200582; odds ratio [OR], 6.00 [95% confidence interval {CI}, 2.70\u201313.33]) and children reporting \u22652 symptoms (n\u2005=\u2005365; OR, 5.25 [95% CI, 2.66\u201310.38]) were significantly more likely to have a positive COVID-19 test than asymptomatic children (n\u2005=\u2005155), but they were not significantly different from each other (OR, 0.88 [95% CI, .52\u20131.49]). Sensitivity and PPV were highest for isolated fever (33% and 57%, respectively), cough (25% and 32%), and sore throat (21% and 45%); headache had low sensitivity (8%) but higher PPV (33%). Sensitivity and PPV of isolated congestion\/rhinorrhea were 8% and 9%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With high Delta variant prevalence, children with isolated symptoms were as likely as those with multiple symptoms to test positive for COVID-19. Isolated fever, cough, sore throat, or headache, but not congestion\/rhinorrhea, offered the highest predictive value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac112","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T07:21:40Z","timestamp":1646810500000},"page":"1131-1139","source":"Crossref","is-referenced-by-count":4,"title":["Predictive Value of Isolated Symptoms for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children Tested During Peak Circulation of the Delta Variant"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9309-6205","authenticated-orcid":false,"given":"Adrianna L","family":"Westbrook","sequence":"first","affiliation":[{"name":"Pediatric Biostatistics Core, Department of Pediatrics, Emory University , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura C","family":"Benedit","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer K","family":"Frediani","sequence":"additional","affiliation":[{"name":"Nell Hodgson Woodruff School of Nursing, Emory University , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"},{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabeel Y","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia R","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"},{"name":"Division of Pediatric Emergency Medicine, Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina A","family":"Rostad","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"},{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl L","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam B","family":"Vos","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"},{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Welsh","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"},{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Wood","sequence":"additional","affiliation":[{"name":"Pediatric Biostatistics Core, Department of Pediatrics, Emory University , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg S","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilbur","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, Georgia , USA"},{"name":"Aflac Cancer and Blood Disorders Center of Children\u2019s Healthcare of Atlanta , Atlanta, Georgia , USA"},{"name":"Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nira R","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Boston Children\u2019s Hospital , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,10]]},"reference":[{"key":"2022093020243550700_CIT0001","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.15585\/mmwr.mm7036e1","article-title":"Trends in COVID-19 cases, emergency department visits, and hospital admissions among children and adolescents aged 0-17 years\u2014United States, August 2020-August 2021.","volume":"70","author":"Siegel","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022093020243550700_CIT0002","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.15585\/mmwr.mm7036e2","article-title":"Hospitalizations associated with COVID-19 among children and adolescents\u2014COVID-NET, 14 states, March 1, 2020\u2013August 14, 2021.","volume":"70","author":"Delahoy","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022093020243550700_CIT0003","article-title":"COVID-19 testing program, COVID-19 protocols flowcharts.","author":"Massachusetts Department of Elementary and Secondary Eduction.","year":"2021"},{"key":"2022093020243550700_CIT0004","article-title":"Changes and updates: COVID-19 guidance for Georgia K-12 schools and school-based programs.","author":"Georgia Department of Public Health.","year":"2020"},{"key":"2022093020243550700_CIT0005","article-title":"COVID-19 recommendations checklist for K-12 schools and other school-based programs.","author":"San Mateo County Health, Public Health, Policy, and Planning.","year":"2021"},{"key":"2022093020243550700_CIT0006","doi-asserted-by":"publisher","DOI":"10.1101\/2021.10.06.21264467","article-title":"Illness characteristics of COVID-19 in children infected with the SARS-CoV-2 Delta variant.","author":"Molteni","year":"2021","journal-title":"medRxiv [Preprint]. Posted online 7 October"},{"key":"2022093020243550700_CIT0007","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1109\/OJEMB.2021.3070825","article-title":"The RADx tech test verification core and the ACME POCT in the evaluation of COVID-19 testing devices: a model for progress and change.","volume":"2","author":"Nehl","year":"2021","journal-title":"IEEE Open J Eng Med Biol"},{"key":"2022093020243550700_CIT0008","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1056\/NEJMsr2022263","article-title":"Rapid scaling up of Covid-19 diagnostic testing in the United States\u2014the NIH RADx initiative.","volume":"383","author":"Tromberg","year":"2020","journal-title":"N Engl J Med"},{"key":"2022093020243550700_CIT0009","article-title":"SARS-CoV-2 variant surveillance program","author":"Centers for Disease Control and Prevention","year":"2021"},{"key":"2022093020243550700_CIT0010","article-title":"School aged COVID-19 surveillance data","author":"Georgia Department of Health","year":"2021"},{"key":"2022093020243550700_CIT0011","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: elegant graphics for data analysis","author":"Wickham","year":"2016"},{"key":"2022093020243550700_CIT0012","article-title":"COVID data tracker","author":"Centers for Disease Control and Prevention","year":"2021"},{"key":"2022093020243550700_CIT0013","article-title":"Screening K-12 students for symptoms of COVID-19: limitations and considerations.","author":"Centers for Disease Control and Prevention.","year":"2020"},{"key":"2022093020243550700_CIT0014","article-title":"COVID-19 testing guidance, testing indications","author":"American Academy of Pediatrics","year":"2021"},{"key":"2022093020243550700_CIT0015","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S2352-4642(21)00198-X","article-title":"Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2.","volume":"5","author":"Molteni","year":"2021","journal-title":"Lancet Child Adolesc Health"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciac112\/43679312\/ciac112.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/7\/1131\/46227345\/ciac112.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/7\/1131\/46227345\/ciac112.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T16:31:16Z","timestamp":1664555476000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/75\/7\/1131\/6546602"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,10]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,5,10]]},"published-print":{"date-parts":[[2022,9,30]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciac112","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.12.17.21267993","asserted-by":"object"}]},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,5,10]]}}}